Basic Med Or How to become an Aviation Medical Examiner Without even trying

Pilots Approx 594,000 pilots in US Over 200, 000 are private pilots 750,000 physicians around 600,000 in direct patient care About 1/3 are involved in primary care Most of us have or will see a pilot in our practice

Types of Pilots Ultralight, light sport, recreational, private, commercial, airline transport pilot Hang glider, glider, balloon, gyrocopter, helicopter Single engine, multiengine, turboprop, jets Seaplanes, lawnchair balloon Each type of pilot and what he flies may require a different type of medical certificate or none at all

Types of Medical Certificates Glider, balloon, light sport, ultra light- DL Private, recreational class 3 Commercial class 2 Airline Transport Pilot-class 1 Medicals required to be done by AME Now-- Private and Rec pilots can do Basic MED Alternative to 3d class medical

Basic Med Part of Pilot Protection Act ll Signed July 15, 2016 AOPA & EAA FAA too strict on medicals for 3d class Why does all this matter Coming to you

What is Basic Med Alternative to 3d class medical for recreational and private pilots Can be performed by a state licensed physician Leaves the FAA out of the loop Consists of a Comprehensive medical exam and an online test Can be performed by an AME but not required

Basic Med Requirements for Pilots Has to have a valid DL Has to have had a medical in last 10 years Last medical cannot have been revoked Cannot be first time medical Cannot have had legal action taken on pilot Can have a letter of special issuance

How is it done Airman downloads form from FAA website and completes it Airman takes form to his physician Physician goes over form and does comprehensive exam Physician signs attestation Airman takes form and goes online, signs attestation, inputs MD s info and takes an online course and exam, and submits Downloads certificate of completion and stores in safe place Physician exam q 4 years Online test q 2 years

Privileges GO FLY!! Aircraft requirements No more than 5 passengers No faster than 250 knots No higher than 18,000 feet No restrictions on single or multiengine, retractable gear, day or night, VFR or IFR

Restrictions Cardiac Neurologic Mental Require letter of Special Issuance AME FAA One time only

Restrictions Cardiac Myocardial infarction Valve replacement ASCHD requiring treatment Heart transplant Note: Arrthymias, CHF, Long Q-T, Pul. Htn, Hypertrophic subaortic stenosis, ect, not on list

Restrictions cont. Neuro Epilepsy Loss of consciousness without satisfactory explanation of cause Transient loss of any nervous system functions without satisfactory explanation of cause

Restrictions cont. Mental Personality Disorder with overt manifestations Psychosis Bipolar disorder Substance dependence Will require 3d class and referral to FAA for letter of special issuance

Form

FAA Disqualifications Same as prev noted Plus cancer, Plus arrhythmias, other heart conditions Plus diabetes Plus htn Plus medications Plus a whole host of other things

Medications Classes Do not issue- Do not fly Angina meds Anticholinergics Cancer treatments Controlled substances Diabetic meds, SGLT-2 inhibitors, insulin, combinations Dopamine agonist Pain meds other than Tylenol or nsaids

Med Classes cont Centrally acting hypertensives Antimuscarinics- oxybutynin, solifenacin Antidepressants ADD Antipsychotics Antianxiety Seizure

Meds cont Smoking cessation High dose steroids Weight loss Alcohol Any Med may cause drowsiness or careful operating machinery Includes OTCs

Summary of FAA Standards Vison-20/40 distant and near Color- able to see colors Hearing conversation voice BP- 155/95 EKG- not routinely required Mental no psychosis, bipolar, or personality Substance abuse preceding 2 years Plus everything previous

Benefits See a physician that knows them well Better physical Uses physicians knowledge and expertise Airman more comfortable Address medical issues Typically will have less requirements than FAA Easier to get information

Drawbacks Increased liability- civil as opposed to malpractice Federal document falsification has consequences Malpractice carriers may not cover Risk of alienating a patient Extra work in busy office Responsibility of certifying pilot is good to fly Airman may only get medical every 4 years

Summary Decide if you want to do this Check with Malpractice carrier You are responsible party for certification Utilize this for better care of your patients Comprehensive Use resources for guidance Use knowledge and judgement

Resources General guidelines FAA.gov/go/ameguide Disqualifying meds FAA.gov/go/dni AOPA.org- Basic Med EAA.org-Advocacy & Safety-Basic Med Mayo Clinic- Aerospace medicine??? Local AME FAA-NOT